Requirement of Intravenous Fluid and Insulin in the Management of Diabetic Ketoacidosis to Overcome the Crisis: Experience in a Specialized Hospital

Authors

  • Rozana Rouf Dept. of Endocrinology, BIRDEM, Dhaka
  • Murad Rahim Asst. Prof., Dept. of Nephrology, BIRDEM, Dhaka
  • Zafar Ahmed Latif Prof. of Endocrinology and Academic Director, BIRDEM, Dhaka

DOI:

https://doi.org/10.3329/jom.v19i1.34835

Keywords:

Diabetes Mellitus, Diabetic Ketoacidosis, Insulin, Intravenous Fluid

Abstract

Background: Among the acute metabolic decompensation states of diabetes mellitus, diabetic ketoacidosis (DKA) is relatively common. It commonly occurs in diabetic patients who have given up taking insulin or who have got some sort of infection. Treatment consisted of correction of dehydration, hyperglycaemia, electrolyte imbalance, acidosis and antibiotics for the patients who have some sort of infection or treatment of other precipitating cause, if present.

Methods: This cross sectional study was performed in BIRDEM Hospital in 2012 on fifty adult diabetic ketoacidosis patients who fulfilled inclusion and exclusion criteria to find out the total amount of intravenous fluid (normal saline) needed to treat diabetic ketoacidosis.

Results: DKA occurred more in previously diagnosed (60%) diabetic patients and frequency was more in poor, village people and there was no significant sex differences. Along with polyuria (24%) and polydipsia (16%), nausea (32%), vomiting (48%), abdominal pain (28%) and feature of infection were common. Infection (38%) and omission of insulin doses (34%) were the main cause. The glycaemic status was poor in most cases. Most patients had mild (32%) to moderate (60%) acidosis and gross electrolyte disturbance was not that much common. Leukocytosis (88%) was invariably present, even without any infection. Outcome (90% survival) was comparable with developing world. In management of DKA 40% patients required 11 liters of fluid, who had increased diuresis. 24% patients required 91-100 units of insulin, and most (32%) patients took 48 hours for correction of acidosis

Conclusions: Diagnosis and treatment of diabetic ketoacidosis is not difficult if recognized early. Adequate fluid replacement is important to prevent the mortality.

J MEDICINE Jan 2018; 19 (1) : 18-21

Downloads

Download data is not yet available.
Abstract
1
PDF
1

Downloads

Published

2017-12-07

How to Cite

Rouf, R., Rahim, M., & Latif, Z. A. (2017). Requirement of Intravenous Fluid and Insulin in the Management of Diabetic Ketoacidosis to Overcome the Crisis: Experience in a Specialized Hospital. Journal of Medicine, 19(1), 18–21. https://doi.org/10.3329/jom.v19i1.34835

Issue

Vol. 19 No. 1 (2018)

Section

Original Articles

License

Authors who publish with this journal agree to the following terms:

    1. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.

    1. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.

  1. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).